- Community Health Systems (Franklin, TN)
- …appropriateness, and efficiency of hospital services to ensure compliance with utilization management policies. This role conducts admission and continued ... extended stays, identifying opportunities for process improvements to enhance utilization management . + Serves as a key...Compact State Licensure required + CCM - Certified Case Manager preferred or + Accredited Case Manager … more
- CenterWell (Nashville, TN)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- Community Health Systems (Franklin, TN)
- …preferred **Knowledge, Skills and Abilities** + Strong knowledge of utilization management principles, payer requirements, and healthcare regulations. ... Summary** The Utilization Review Coordinator ensures efficient and effective management of utilization review processes, including denials and appeals… more
- Highmark Health (Nashville, TN)
- …This role supports the full application product lifecycle for **clinical and utilization management software** , with a specific focus on driving ... They function as a pivotal bridge, translating high-level **clinical and utilization management software** business needs into detailed technical requirements… more
- Cherry Bekaert (Nashville, TN)
- …domain, an opportunity has been created for a Manager with a key focus on grants management ... Join the Firm that recognizes the power of the individual. **As a GPS Manager , you will:** Grow the practice through expansion of services to existing clients and… more
- Select Medical (Nashville, TN)
- …by doing what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning, treatment plan management ... within the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates UR compliance with… more
- Select Medical (Nashville, TN)
- …by doing what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning, treatment plan management ... **Overview** **Critical Illness Recovery Hospital** **Case Manager (PRN)** _Requires a current licensure in a...the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates… more
- Select Medical (Nashville, TN)
- …by doing what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning, treatment plan management ... within the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates UR compliance with… more
- Oracle (Nashville, TN)
- …Services team is seeking a Manager over Adoption Consultants. This manager will be responsible for people management , partner program, practice outcomes, ... and organizational development. Our Adoption Consulting Manager plays a critical role in maximizing customer and caregiver value. The Strategic Analytics & Adoption… more
- Wellpath (Franklin, TN)
- …make a difference** The Regional Care Manager (RCM) is responsible for utilization review, care coordination, and daily care management across multiple sites ... or Care Management Certification + RN preferred EXPERIENCE + Previous utilization review and/or case management and pre-certification experience + Knowledge… more
- CBRE (Nashville, TN)
- Workplace Strategy & Occupancy Planning Manager Job ID 250685 Posted 08-Dec-2025 Service line GWS Segment Role type Full-time Areas of Interest Workplace Strategy ... of America **About The Role:** As a CBRE Workplace Strategy & Occupancy Planning Manager , you will play a crucial role in optimizing our real estate portfolio,… more
- Centene Corporation (Nashville, TN)
- …or medical group experience, provider relations, quality improvement, claims, contracting utilization management , or clinical operations. Project management ... align on network performance opportunities and solutions, and consultative account management and accountability for issue resolution. Drive optimal performance in… more
- Oracle (Nashville, TN)
- …process from requirement intake, design, build, testing and deployment. + Works closely with management - Portfolio Manager and the roles within the pods (eg, ... and goal setting for the department or function in collaboration with senior management . + Drive the deployment of Customers workloads to Oracle Cloud by providing… more
- The Hertz Corporation (Nashville, TN)
- The Manager Maintenance Support Services role is to oversee the team contained within the maintenance support services facility. It is their responsibility to ensure ... out of service rates, and maintaining high-vehicle quality across the division. The Manager will be familiar with vehicle mechanical repairs as well as minor body… more
- Baylor Scott & White Health (Nashville, TN)
- **JOB SUMMARY** 100% remote position** The Medical Trend Analytics Manager 1 is responsible for leading the design, execution, and communication of analytical output ... that identifies cost, utilization , and clinical trends across the organization. This role...business acumen and communication skills. The Medical Trend Analytics Manager 1 manages a team that provides advanced medical… more
- HCA Healthcare (Nashville, TN)
- …and evaluate changes in formulary strategy including exclusions, tier changes, and utilization management updates + Working knowledge of employee pharmacy ... RPh designation + Minimum 3+ years of strategic account management experience with a pharmacy benefit manager ...account management experience with a pharmacy benefit manager and/or a large employee benefit consulting firm with… more
- Capital One (Nashville, TN)
- …to be regularly worked. Remote (Regardless of Location): $140,600 - $160,400 for Sr Manager , Process Management Richmond, VA: $140,600 - $160,400 for Sr ... information into user-friendly content that enables successful onboarding and utilization of Databolt by customers, partners and internal stakeholders....Manager , Process Management Candidates hired to work in other locations will… more
- Eliassen Group (Nashville, TN)
- **Project Manager - Observability and Monitoring** **Anywhere** **Type:** Consulting **Category:** Delivery Leader **Industry:** Financial Services **Workplace ... client in the Financial Services Industry is seeking an experienced Project Manager to lead a critical enterprise-wide observability and monitoring initiative. This… more
- HCA Healthcare (Nashville, TN)
- …testing plans and events, go live activities, support, and optimization. + Management of resource utilization and project assignments, prioritization of task ... purpose and integrity. We care like family! Jump-start your career as a Manager Meditech Consulting Service today with CereCOre, part of HCA Healthcare. **Benefits**… more
- Stantec (Nashville, TN)
- …building our clean energy future. Your Opportunity We are seeking a Project Manager for our Energy & Resources business line to lead multi-discipline project teams ... services for simple cycle, combined cycle, and/or repowering projects. The Project Manager will provide leadership to these state-of -the-art projects to support… more